Citation Nr: 21063316 Decision Date: 10/13/21 Archive Date: 10/13/21 DOCKET NO. 16-58 646 DATE: October 13, 2021 REMANDED Entitlement to service connection for anemia is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Navy from August 1972 to May 1975. In June 2019, the claim was brought before the Board and was remanded for further development. Entitlement to Service Connection: Anemia Although the Board regrets further delay, another remand is required to provide the Veteran with every possible consideration. The Board finds that the Veteran has not been afforded a VA examination for the claim on appeal. VA's duty to assist includes providing a medical examination and obtaining an opinion when it is necessary to make a decision on a claim. 38 U.S.C. § 5103A(d) (2012); 38 C.F.R. § 3.159 (2020). Such development is necessary if the information and evidence of record does not contain sufficient competent medical evidence to decide the claim, but (1) contains competent evidence of a diagnosed disability or symptoms of disability, (2) establishes that the Veteran suffered an event, injury or disease in service, or has a presumptive disease during the pertinent presumptive period, and (3) indicates that the claimed disability may be associated with the in-service event, injury, or disease, or with another service-connected disability. 38 C.F.R. § 3.159(c)(4); McLendon v. Nicholson, 20 Vet. App. 79, 83-86 (2006). The threshold for finding a link between a current disability and service so as to require medical examination is low. Locklear v. Nicholson, 20 Vet. App. 410 (2006); McLendon, 20 Vet. App. at 83. Here, the evidence of record shows the Veteran has been diagnosed with anemia. Further, the Veteran has contended that his anemia is related to exposure to herbicides, and his records confirm he was stationed on the USS Rowan, which was in qualifying offshore waters under the Blue Water Navy Vietnam Veterans Act of 2019, Public Law 116-23. Therefore, exposure to herbicides is presumed. The Board also notes that although anemia is not considered a disability for presumption purposes under 38 C.F.R. § 3.309(e), it does not preclude the Veteran from receiving a VA examination with an opinion on whether his condition is directly related to herbicides. Given the above, the Board finds that a remand is required in order to obtain an examination with an opinion on the etiology of the claimed condition. McLendon v. Nicholson, 20 Vet. App. 79 (2006). The matters are REMANDED for the following action: Schedule the Veteran for a VA examination with an appropriate examiner to determine the etiology of the Veteran's anemia. The examination may be conducted via telehealth or similar service during the social distancing restrictions of the COVID-19 pandemic. If the Veteran is unable to attend a VA examination, then the file should still be sent to an examiner for the requested opinion. The record and a copy of this Remand must be made available to the examiner. Following a review of the entire record, to include the Veteran's lay statements concerning any in-service symptoms, the examiner should opine as to the following: Is at least as likely as not (i.e., a 50 percent or greater probability) that the Veteran's anemia had its onset during, or is otherwise related to, his active duty service, to include his presumed exposure to herbicides? In offering any opinion, the examiner must consider the full record, to include the lay statements regarding in-service incurrence, and the opinion should reflect such consideration. A clearly stated rationale for any opinion offered should be provided and must not be based solely on the lack of any in-service records. If the examiner is unable to provide an opinion without resort to speculation, he or she should explain whether the inability is due to the limits of the examiner's medical knowledge, medical knowledge in general or there is evidence that, if obtained, would permit the opinion to be provided. JENNIFER HWA Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J. Negron, Counsel The Board's decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.